Objective: To compare the significance of the application of the working definition for metabolic syndrome (MS) proposed by the World Health Organization (WHO) in 1999 and the one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) in 2001.
Methods: Data of 2048 subjects, aged 20-74, 896 males and 1152 females, with complete laboratory data, including plasma glucose, lipid profile, blood pressure, serum insulin, urine albumin and creatinine, were gathered from the data of baseline survey on obesity and its co-morbidities conducted in Huayang and Caoyang communities, Shanghai, from 1999 to 2001. MS was diagnosed according to these two definitions respectively.
Results: (1) The age-adjusted MS prevalence rates were 17.14% and 10.95% according to the WHO (1999) and ATP III (2001) respectively, the former being significantly higher than the latter. (2) A total of 445 subjects were diagnosed as having MS. The agreement in the diagnosis of MS using two definitions was about 45.17%. 42.02% of the subjects had MS only under the WHO (1999) definition, while 12.81% of the subjects had MS under the ATP III (2001) definition. (3) The prevalence rate of hyperglycemia and central obesity as defined by WHO (1999) definition were 1.74 and 4.38 times higher than those defined by ATP III (2001) definition (16.74% vs 9.57%, 33.04% vs 7.54% respectively). (4) In comparison with non-MS subjects, the body mass index, waist-to-hip ratio, blood pressure, blood glucose, insulin resistant index (HOMA-IR), and albumin-to-creatinine ratio were all significantly increased in MS subjects.
Conclusion: Both definitions for MS can reflect the clustering degree of risk factors of cerebrovascular and cardiovascular diseases. The WHO definition of MS can better reflect the characteristics of MS in Chinese than the definition proposed by ATP III, however it needs more measurements and costs more. A simple method with high detection ability remains to be worked out.